OBJECTIVE: To describe our experience with bladder endometriosis at the Department of Urology of Complejo Hospitalario Universitario de Santiago de Compostela. METHODS: We performed a retrospective analysis of the cases of bladder endometriosis diagnosed during the last 11 years in our hospital, from January 2000 to December 2011. RESULTS: A total of 7 women, with a mean age of 32-year-old have been diagnosed by biopsy of bladder endometriosis. The most common symptoms were dysuria, suprapubic pain, urinary urgency and hematuria. All patients have undergone surgery (5 transurethral resection, 2 partial cystectomy), 6 of them were also treated with post-operative LHRH analogues. CONCLUSIONS: Endometriosis is a common disease in young women, but the involvement of the urinary tract is unusual. There are multiple therapeutic options; despite this there exists a high probability of recurrence.
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The relationships between cytokine responses in septic shock are currently poorly understood. Some studies have pointed to a biphasic model, with an initial proinflammatory phase, followed by a reactive, anti-inflammatory response to explain the pathogenesis of the most severe form of sepsis. However, evidence for the coexistence of both responses has been found. In this study, the plasma levels of 17 cytokines and chemokines, in 20 patients with septic shock, 11 patients with systemic inflammatory response syndrome (SIRS), during the first 24 hours following diagnosis, and 10 healthy controls, were analyzed and compared. Patients with septic shock showed increased levels of IL-6, IL-8, MCP-1, MIP-1β, IFN-γ, GM-CSF and IL-10 compared to healthy controls. Patients with SIRS showed higher levels of IL-6, IL-8, MCP-1, MIP-1β, G-CSF and IL-10 than controls. Patients with septic shock showed higher levels of IL-8, GM-CSF, MIP-1β than those with SIRS. The Spearman test demonstrated a positive association between the pro-inflammatory mediators IL-6, IL-8, MCP-1, MIP-1β, IFN-γ, GM-CSF and the immunomodulatory cytokine IL-10 in septic shock. Consequently, correlation studies supported the notion that secretion of pro- and anti-inflammatory mediators in septic shock occurs as a simultaneous immune response program initiated early in the course of the disease, revealing that both types of cytokine play a role from the very beginning of this life-threatening condition.
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